Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Angry Patients

The goal of medical care in workers compensation is to return patients to their pre-injury health, and when possible, return them to work. The majority of injured workers share this goal and make up the preponderance of medical-only cases.

The reluctant worker (often seen by others as unmotivated or benefitting from secondary gain) is too often seen as someone who can be forced into returning to work. This employee will not return to their job if:

they anticipate the unspoken goal is to fire themthere is open animosity with coworkers and/or superiorstheir medication alters attention, concentration and coordination, increasing risk of injury to self or othersthey have become de-conditioned and are not competent to fulfill job requirements, even though they are not technically disabled from doing sothey anticipate confrontation with, or from, a coworker involved in their injurythey are in settings where the physical risk factors that led to injury have not been addressed by the employertheir limitations are not honored by the employer or are doubted by coworkers who resent the light duty offered the patient they are placed in alternate settings in which the patient is knowingly assigned menial (or no productive) tasks resulting in boredom and resentmenttheir physician releases them to work on paper but does not share this change in condition with the injured workerThus we see that the primary disincentives to work include compromised health, unsafe conditions, suspicion, unresolved ill-will, and lack of meaningful work. Until/unless these are resolved, actions that attempt to force the patient in an undesirable direction will simply engender distrust and decreased compliance.”